Why Weight Loss is Out and Body Recomp is In


From my work in obesity medicine at UCLA’s weight loss clinic, where we see about 140 people on a Saturday morning, I answer questions all the time about weight loss goals, what’s an ideal body weight, and the targeted strategies to reach these goals. My favorites are the frustrating questions about why the numbers on a scale aren’t moving in the expected direction, despite following every detail in the program. I love this one, because it really shows the difference in outcomes.

In one example, there’s someone who’s kind of, sort of doing the nutrition component of the program, maybe not fully meeting their protein goals, and rarely engaging in fitness. The scale looks like it’s going ok, with the pounds coming off. However, we then take a look at their body composition numbers and it’s a whole different story. Those -10 pounds are coming primarily from muscle loss, and only a couple pounds from fat mass loss. That’s just a terrible situation. Not only have you lost lean muscle tissue that helps keep up your basal metabolic rate, it’s also likely that the weight will come back on if you go back to the eating habits from the past. It’s not a good outcome, but a great teachable point in the program.

On the other side of the spectrum we have those who are getting super frustrated, even though they’ve been following the calorie and nutrition guidelines, have been meeting the exercise goals and even adding in the resistance training a couple of times per week. But the scale has barely budged. How, after all this time and effort, does it not show in the numbers? Then we evaluate the body composition findings and see the gold medal results. Those -5 pounds are coming from a loss of 5 pounds of fat mass and a preservation of the lean muscle tissue. By preserving that basal metabolic rate with the lean tissue, they are in a much better position to keep that weight off for good.

The key here is that these are long-term wins. Enhancing the amount of muscle takes longer with caloric restriction, which is why Body Recomp isn’t part of the fad quick weight loss ads. No thanks to skinny fat and a subpar fat-to-muscle ratio, which is definitely not a good strategy for your health and hormones. It’s definitely worth it for the long-term, as it means you’re combining the right nutrition program with smart strength and conditioning workouts. So good that the data shows a 23% reduced mortality from all causes from just 2 or more training sessions a week. Maybe it’s related to the protective effect of skeletal muscle on cardiometabolic disease. I’ll take that.


Emmanuel Stamatakis, I -Min Lee, Jason Bennie, Jonathan Freeston, Mark Hamer, Gary O’Donovan, Ding Ding, Adrian Bauman, Yorgi Mavros, Does Strength-Promoting Exercise Confer Unique Health Benefits? A Pooled Analysis of Data on 11 Population Cohorts With All-Cause, Cancer, and Cardiovascular Mortality Endpoints, American Journal of Epidemiology, Volume 187, Issue 5, May 2018, Pages 1102–1112

Kim Y., Han B.-D., Han K., Shin K.E., Lee H., Kim T.R., Cho K.H., Kim D.H., Kim Y.H., Kim H., et al. Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009–2010. Endocrine. 2015;50:424–433.

Ramírez-Vélez, Robinson, et al. "Fat-to-muscle ratio: A new anthropometric indicator as a screening tool for metabolic syndrome in young colombian people." Nutrients 10.8 (2018): 1027.

Srikanthan P., Karlamangla A.S. Relative Muscle Mass Is Inversely Associated with Insulin Resistance and Prediabetes. Findings from the Third National Health and Nutrition Examination Survey. J. Clin. Endocrinol. Metab. 2011;96:2898–2903.

Xu K., Zhu H.J., Chen S., Chen L., Wang X., Zhang L.Y., Pan L., Wang L., Feng K., Wang K., et al. Fat-to-muscle Ratio: A New Anthropometric Indicator for Predicting Metabolic Syndrome in the Han and Bouyei Populations from Guizhou Province, China. Biomed. Environ. Sci. 2018;31:261–271.

Ready for a Summer ReBoot?

Long weekends .... good friends ... relaxing by the water ... kombucha on draft ... sounds like a fun and refreshing summer ahead!

With July right at our doorstep, your wellness and fitness reboot is likely about to get into high gear, getting prepped for those beach days and active outings. In need of a re-commitment to eat a wee bit better, get some more movement in, and replenish the spiritual side as the days get hotter?

With all this intention, what about the plan? How do we go about effectively reaching our summer goals with a reboot?  

Can we take insights from key organization concepts to help restructure what’s working and what’s not? To help pave the way for not only a lean and clean eating plan, but also for svelte surroundings? Our habitat shapes many of our auto-pilot actions, driving us to be either more likely to be successful or farther and farther away from our vision of our best daily self.

Here are some ideas from Cornell’s Food & Brand Lab on how to structure yourself for success:

·      Keep counters clear of all foods but healthy ones

·      Avoid eating directly from a package: always pre-portion food

·      Eat something hot for breakfast within the first hour of waking up

·      Avoid going more than 3-4 hours without eating something small

·      Put your utensils down between bites to slow down your eating

In the Summer Reboot, we’ll explore how to set yourself up to be a spectacular success: organizing your life for wellness and a healthy clean eating strategy to take it all to the next level, even with those mojito weekends!


Proud to partner with Maeve's Method, specialists in organization, for this event!


Spring Clean: How to Amplify your Metabolism for Weight Loss

Spring Clean: How to Amplify your Metabolism for Weight Loss

If it's been a struggle to lose weight and keep it off with the same old diet and cardio program, then it's missing a key piece that's very important to be successful. Learn why strength training is what will make the difference in boosting your metabolic rate, improving what your body is made of by breaking down fat and building muscle, and in helping you finally reach those fitness goals. 

January Refresh Part 1: Clear the Clutter!

In need of a reset this holiday season? You’re not alone! Most people gain weight during the holidays, which can take over 5 months to lose![1] In the US, weight patterns being to rise around Thanksgiving and peak around Christmas and New Year. So are you ready to get a head start and not wait until Easter to bring it back to your norm or goal weight?

The first step begins with your surroundings and setting yourself up for success.

“Cluttered and chaotic environments can cause stress, which can lead us to grab more of the indulgent snacks - twice as many cookies according to this study that showed cluttered kitchens are caloric kitchens

When stressed out women were asked to wait for another person in a messy kitchen - with newspapers on the table, dishes in the sink, and the phone ringing – they ate twice as many cookies compared to women in the same kitchen when it was organized and quiet. In total they ate 53 more calories from cookies in 10 minutes time.

What also matters is your internal state and feeling of control, “Some of the participants were asked to write about a time when their life was out of control and others were asked to write of a time when they were in control.  The latter group entered the cluttered room feeling in control and ate about 100 fewer total calories than those who felt out of control before entering.”

“Although meditation, as a way of feeling in control, might be one way to resist kitchen snacking for some, it’s probably easier just to keep our kitchens picked up and cleaned up,” said coauthor Brian Wansink, Director of the Cornell Food and Brand Lab.[2] Although a chaotic environment can create a vulnerability to making unhealthy food choices, one’s mind-set in that environment can either trigger or buffer against that vulnerability.

Why not become a superstar in both?? Join us this January 12th with organizing expert Maeve Richmond and Lifestyle Medicine Dr. Ingrid Edshteyn to set yourself up for success in the kitchen and in your life!

Early Bird & Primary Member Specials before January 6th: Reserve your ticket here

[1] http://www.nejm.org/doi/full/10.1056/NEJMc1602012

[2] http://journals.sagepub.com/doi/abs/10.1177/0013916516628178


Taking the Lead on 2017: A Not-So-Secret Advantage

We've all been there, feasting for the holidays that begins on Thanksgiving, spiked with a few holiday parties, and the grand all out finale by the time New Year's hits. In between there's a streak of days with concerted effort to 'reform' from all these indulgences with a hard-core cleanse or two. Something really disciplined to bring us back in line and hopefully down a size by the 25th, or at least the 31st. Usually it involves some lovely form of caloric deprivation, whether soups, smoothies, or stews, and some extra spin sessions or HIIT classes.

And then January rolls around and it's time to really get serious. With a clean eating plan and lots of gym time. Early, really early in the morning. We can see all that extra packaging dropping off, revealing the real fit and lean version that's ready to take on 2017. 

But somehow we get stuck again, where it works well for a bit, we lose some weight with all the extra cardio and clean eating, but feel short-changed on the vision of the "New You." 

Well it's not a shocker - losing extra adipose poundage isn't easy. Our resting and non-resting energy expenditure decreases, and our satiety hormone - leptin - decreases, leaving us feeling less satisfied and more hungry. All the time. 

So are we missing something, a "secret ingredient," to our training? 

Well, we know that skeletal muscle is the primary organ causing the decline in our non-resting energy (NREE) expenditure. It gets more efficient as we lose weight. Say you were to lose 10% of your weight by eating less calories than you need. Your skeletal muscle just dropped your NREE by 75% This is a big part of why you can't go back to eating the same number of calories. Your body's energy expenditure went down, so less calories in to keep it off.

And say you decided to do a very low calorie diet (500 kcal/day) to drop those pounds. Well, may as well have done a low-calorie option (1250 kcal/day) instead, as the weight loss is similar. The authors of that article hit on a key factor to why we regain weight: because the calorie restriction is causing a loss of muscle mass! The % of muscle mass lost was associated with weight regain - as much as 8.8% muscle mass lost in that super low calorie group!

So why is this Not-So-Secret? Because we've already known for almost 30 years that strength training while reducing calories not only reduces weight as much as those who just diet, but also results in maintaining all that precious muscle! And we just saw how critical it is in preventing weight regain. Bottom line, if your "New You" training program is just cutting calories and not building strength, there's definitely an upgraded version available for your sustainable success. 

So as you get ready for the holiday feasting and fasting, here's to a slogan that can bring some bipartisan support for the #win in 2017

#makeamericaliftagain #strongertogether

Our Integrative Fitness Programs

The 3 P's of the Microbiome Diet

When I think about my top diet tip, I think about nourishing not just myself, but the 100 trillion microorganisms in my digestive tract, which is at least on the same order as the number of cells in our bodies.[1][2]

What do we need these microbes for? In addition to digesting food, they’re also playing a part in ensuring the integrity of our gut lining. If they’re doing their job, beneficial bacteria produce fermentation by-products, like short chain fatty acids, that are key in keeping the gut lining strong and the cell junctions normal - preventing a number of immune problems like asthma and arthritis, along with irritable bowel syndrome, weight issues and even depression. [3],[4],[5]

One very neat study, a microbiome transplant we’ll call it, showed that mice receiving bugs from a heavier body weight twin, ended up becoming significantly fatter than the ones getting the transplant from the lean twin. [6] This means our microbes may matter more than we’ve thought for our metabolic regulation. 

The strategy then is to start with a sustainably healthy microbiome, with prebiotics, probiotics, and polyphenols. Prebiotics are parts of plants and provide food for the beneficial bacteria in the colon (things like garlic, leeks, and onions), and polyphenols are the plant-derived chemicals that live in abundance in colorful fruits and veggies, especially berries.[7] A foundation of whole plant foods and a good probiotic source puts us well on our way to a flourishing microbiome and is the daily nutrition tip I live by since it’s made a substantial difference with my own GI health and energy levels. In combination with identifying food sensitivities for a personally optimized diet, those 3 P’s form the daily diet cornerstone. 

Find out more about our precision integrative nutrition program with Francesca Alfano!


[1] Tremaroli, Valentina, and Fredrik Bäckhed. "Functional interactions between the gut microbiota and host metabolism." Nature 489.7415 (2012): 242-249.

[2] Sender, Ron, Shai Fuchs, and Ron Milo. "Revised estimates for the number of human and bacteria cells in the body." BioRxiv (2016): 036103.

[3] Belkaid, Yasmine, and Timothy W. Hand. "Role of the microbiota in immunity and inflammation." Cell 157.1 (2014): 121-141.

[4] Campbell, Anthony Keith, et al. "Bacterial metabolic ‘toxins’: a new mechanism for lactose and food intolerance, and irritable bowel syndrome." Toxicology 278.3 (2010): 268-276.

[5] Lam, Yan Y., et al. "Role of the gut in visceral fat inflammation and metabolic disorders." Obesity 19.11 (2011): 2113-2120.

[6] Ridaura, Vanessa K., et al. "Gut microbiota from twins discordant for obesity modulate metabolism in mice." Science 341.6150 (2013): 1241214.

[7] Cardona, Fernando, et al. "Benefits of polyphenols on gut microbiota and implications in human health." The Journal of nutritional biochemistry 24.8 (2013): 1415-1422.